1992716005 NPI number — RONALD R COFFEY MD

Table of content: RONALD R COFFEY MD (NPI 1992716005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992716005 NPI number — RONALD R COFFEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COFFEY
Provider First Name:
RONALD
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992716005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
188 QUASSAICK AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW WINDSOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-565-5020
Provider Business Mailing Address Fax Number:
845-565-5027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
188 QUASSAICK AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW WINDSOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-565-5020
Provider Business Practice Location Address Fax Number:
845-565-5027
Provider Enumeration Date:
08/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  141610 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000933 . This is a "CTC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 08016735 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10031951 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2225598002 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2C7753 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5791091 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: OR0000216 . This is a "SELECTPRO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01206477 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 58368 . This is a "OPERATING ENGINEERS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 827719 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 98339 . This is a "US HEALTHCARE AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 350767 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5900820 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2080633 . This is a "US HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 50436 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 115828 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2167821 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".